What is loneliness? A reflection on my Imperial College London Patient Project

ABSTRACT

Loneliness has emerged as a significant public health concern, with profound implications for health outcomes, which can manifest in physical, psychological, and social affliction. Working alongside Fulham Medical Centre, I sought out to create a range of both offline and online resources (YouTube video, ten-episode Spotify podcast, online website, GP practice brochure and poster) designed to provide base learning, practical strategies, community connections and a sense of support to those grappling with loneliness. These resources were well-received by the practice and were implemented on a practice basis, to provide support to the local community. Reflection on this project, highlights the need for student projects, and emphasises the tangible impact that we can have on community support and care for individuals tackling feelings of loneliness.

KEYWORDS:

• Loneliness
• patient project
• resource creation
• community-guided care
• health advocacy
• patient advocacy
• empowering patients

Context

According to a global survey, loneliness affects one-third of the entire world population, and 50% of the adults in London reported feeling lonely in 2022 [1], with nearly 10% of the adults reporting chronic loneliness, with most correspondents reporting feeling lonely, either often, always, or sometimes [2]. Data show that in London, over 700, 000 adults report feeling lonely, with nearly 10% of all Londoners experiencing severe loneliness [3]. This issue has been exacerbated greatly, due in part to the increasing problem of social isolation, a problem which exponentially increased since the COVID-19 pandemic [4]. A CDC report in 2020 [5] found that social isolation significantly increases an individual’s risk of premature death from all causes. Further associations found that loneliness is a direct causative trigger for depression, anxiety, and suicide. Furthermore, alongside psychiatric, and mental health-related issues, loneliness has an impact on physical health too, with loneliness among heart failure patients leading to a near 400% increase in risk of death, 68% increased risk of hospitalisation and 57% increased risk of emergency department visits.

As part of my Year 5 MBBS 3-week GP placement, I was based in the Fulham Medical Centre in London. I interviewed a patient who reported overwhelming levels of loneliness, and she felt that there were inadequate resources available to her in the community, to help tackle these feelings of loneliness and social isolation. Further independent research highlighted a scarcity of support and resources related to this issue. Therefore, I sought to address this issue by creating a plethora of resources for the GP practice that could be provided to individuals as a first point of contact for available information surrounding loneliness.

Project aim

I aimed to address the inherent lack of available resources in the practice population by addressing the key issue of loneliness and creating a set of resources which could be made available to patients in multiple modalities, including video format, leaflet format, website format, poster format and podcast format. I hoped to encourage more conversations surrounding this topic, with medical professionals and give individuals the agency and proactivity to reach out for support when they need it the most.

Description

A discussion with a GP-assigned patient led to a thoughtful and personal discussion on the topic of loneliness, understanding their own personal challenges, unmet needs and experiences in dealing with this pervasive issue. Through these conversations, it became evident that the individual felt a profound sense of social isolation, exacerbated by a perceived lack of resources and support within the healthcare setting. Motivated by these insights, I undertook the initiative to develop a set of bespoke resources tailored to different media, and drawing upon evidence-based knowledge, I created a range of resources which were designed to provide base learning, practical strategies, community connections and a sense of support to those grappling with loneliness.

I created a YouTube video, outlining the different types of loneliness, discussion on support available in the area, as well as giving practical strategies to patients to help them manage their loneliness (see Appendix 1). Furthermore, I created a bespoke website which individuals could access that would allow them to find out more available events and organisations in the local area which offer support, separating these into three distinct categories of active, leisure and talking support services (see Appendix 2). I then created both a GP practice brochure (that could be given as a point of contact to individuals who felt these feelings) and a poster which could be displayed in the waiting room of the practice (see Appendices 3 & 4). Lastly, I created a ten-episode podcast series, uploaded onto Spotify, which housed many meaningful conversations on many topics ranging from, the use of art, talking therapies, and sport, in tackling feelings of loneliness in individuals (see Appendix 5). All these resources coalesced to create a vast range of support and information for individuals in practice.

Outcome

Main outcomes from this project were to have these resources approved by the lead GPs of the Fulham Medical Centre, which would then lead to implementation in a practice-wide attempt to help better manage feelings of loneliness in the community. For unanimous approval, it was agreed to make use of these resources going forward.

Conclusions

On reflection, this project has shown me the importance and power that patient-driven projects can have in the community. Without the initial discussion with the chosen patient, this entire project would not have been able to bear into fruition.

The decision to create resources across multiple media platforms, was driven by a recognition of the diverse preferences and needs of the individuals who may be dealing with issues of loneliness. Loneliness affects individuals differently, hence providing a range of mediums ensured appropriate accessibility and inclusivity, from offline to online resources, from brochures to podcasts, I felt like the project was able to encompass the needs of the majority of individuals. This approach helped to create a broader reach and engagement, accommodating varying styles of consumption of information.

Furthermore, the iterative nature of resource development underscored the importance of ongoing feedback and adaptation. Regular meetings and design reiterations were used, with input from community members, family, and random samplings of the general public, to better understand how to continuously refine and improve these resources. It highlighted the need to be flexible and responsive to individual evolving needs.

I have been astounded by the impact that we can have as medical students when working in partnership with health professionals and patients as a multi-disciplinary team, and I am proud of the project I was able to draft, create and implement in the 3-week time period of the placement.

Acknowledgments

I would like to kindly thank the staff and patients at Fulham Medical Centre, for their help and collaboration in my Patient Project, as well as the GP team at Imperial College London for their educational mentorship, with a particular thanks to Dr Elizabeth Pearson as my GP lead supervisor.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14739879.2024.2364876.

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.